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Metoprolol Concerns (for tachycardia)


   I'm a 26 year old male, and have had 2 EKG's in the past 3 months. One said I had Sinus Tachycardia, and the other one said Supraventricular. I have to pass a Holter but the waiting list is long ( will get it Oct.14 2008 ) but meanwhile my doctor told me to take Metoprolol because my tachycradia is almost 24/7 (with some exceptions, like at night most often) but runs around 120-170 bpm about all day. This caused me lately to be very exhausted and constantly fatigued, and having trouble excercising. It also generated ALOT of anxiety in me.

   So, today I took my first dose, I'm prescribed 2 pills a day of 25 mg. I started with halves though because I was scared my heart would drop TOO low, or my blood pressure too low, because I'm not taking this for hypertension. What concerns me, alot I must say, is some things I read about it. Like I do feel light-headed, dizziness and such, but I'm aware that they may be short-term side-effects (or are they?). What startled me tonight was I felt colder (like chills), and my hands felt slightly cold. I read on wikipedia that "It may also reduce blood flow to the hands and feet, causing them to feel numb and cold"... but can this be dangerous? I mean, isn't blood flow important, and also, can it just be temporary?

   Another thing that alarmed me was here: http://en.wikipedia.org/wiki/Beta_blocker#Side_Effects_.2F_Health_Consequences
Under Health Consequences, it includes stuff like "Impaired Circulation" and "Heart Failure", and it does not say "Possible Health Consequences"... so are these things gonna happen without a doubt or are they just mere possibilities?

   And while I'm at it, are there alot of people who take Metoprolol and have no permanent problems but only beneficial results from this medication? Sorry if I'm bombarding with questions, I just found some sources kind of scary, and also my symptoms which I feared might be long-term so that's why I was wondering if they could wither away.

Thanks to any of you willing to answer.
17 Responses
Avatar universal
Sorry to bump posts, but I just noticed the tag "hypothyroidism svt" was inserted by mistake. I just wanna clarify that I have no thyroid problems, if that can lead to any misjudgement.
Avatar universal
I took 2 different versions of metoprolol, Toprol (metoprolol tartrate) and Toprol XL (metoprolol succinate).  The second one is the extended release version. Toprol made my symtoms worse but Toprol XL worked fairly well in controlling my conditions, PVC's and PSVT.  I was taking 50 mg a day in both cases.  The only thing that affected me was a slight feeling of dizziness at times and some mental fatigue.  I asked my cardiologist to switch me to atenolol and have had better results on 25 mg without any noticable side affects.  However, my heart rate was around 90 with the PSVT and 70 in sinus rhythm without meds.  On 25 mg of atenolol, my resting heart rate was near 60 with BP 116/74.

You do need to get your resting rate down in order to feel comfortable again.  You probably need to take the meds as prescribed for a week or
so and see what happens.  As with all meds, there may be adjustments needed to get the right results.  The percentage of patients who have serious side affects is very, very low.  Remember that beta-blockers like these dilate the blood vessels which results in increased blood flow to the extremities with less work by the heart.  I never liked to take ANY meds but will do so if it is beneficial.  
Avatar universal
First, Sinus Tachycardia is merely a fast heartbeat that is regular and Supraventricular Tachycardia is a fast heartbeat that originates in the atria--the upper chambers.  They're just general labels--it will take further tests to determine exactly what kind of arrythmia you have.

I've been on metoprolol for years.  My resting HR is bradycardic, but it works for me without light-headedness or need to reduce activity.  Metoprolol doesn't seem to do much for my blood pressure, but it's always been in the normal range.  Unfortunately, even on metoprolol, I have breakthroughs and I think the longer you take it, the less effective it gets.  (I'm talking years, here--I've been on this type of medication for almost 30.)

I was switched from atenolol, so the side effects vary by person.  If this is your first experience with fast heartbeats, you should talk to your EP about your symptoms and see if another drug would work better--it may take a while to get the drugs calibrated perfectly.  Are you also taking a blood thinner like Coumadin (generic: warfarin)?  If so, that has to be watched very carefully at first.

But whatever you're on, heart meds have side effects and some of them are scarey.  Most of the really scarey side effects (like heart failure) are almost ridiculously infrequent, still, they're so extreme that people need to know about them so that if they start experiencing the symptoms, they can stop the drug and call their doctor.  Wikipedia probably won't give you the percentages of the side effects--go to the drug's webside or the PDR website and find out.  It will help put your mind at ease.

With some work, you and your cardiologist will find the right combination that will reduce the tachycardia episodes.  One thing that seems a little strange to me is that they're making you wait until October to get a Holter monitor.  You are seeing a cardiologist, right?  An electrophysiologist?  There are reasons for wanting a Holter rather than an event monitor, but it might be a good idea for you to ask why s/he doesn't want you to use an event monitor if there's no Holter monitor available for such a long time.--It's not that your arrhythimia is going to kill you between now and October.  It just seems odd to me that your doctor wouldn't want to find out as much as he can as soon as possible so that he can be sure you're getting the right meds.
Avatar universal
I don't know if my Metoprolol is succinate or tartrate, all it says on the bottle is PMS-Metoprolol-L , but anywhow, I took my second dose thise morning and I've noticed effects I don't like and wondered if they could be temporary, such as inability to have an erection and sometimes like "ticks" in my heart.
Avatar universal
I've been having fast heart rate since a long time, but they've been almost 24/7 since 2 months about. It'Ms not a cardiologist but the doctor at the ER which presribed the Holter, and I imagine if they see anything anormal on the Holter they'll refer to a cardiologist. I then talked to my GP and he prescribed me the Metoprolol.

Thanks alot for your response by the way.
Avatar universal

Having just taken your forst dose of Metroprolol, you haven't even begun to feel the side effects yet.

Due to the long half-life, It takes a good 2 weeks to build up in your system, and probably a month to get the full effect.

I hope you can tolerate the medicine, because it really is effective on tachy. Just FYI, I couldn't tolerate 50mg. I got seriously weak legs and brain fog. Went to 25mg, and within 2 weeks, the side effects were cut in half. Still not pleasant, but well tolerable.

I still can't fathom why you have to wait so long for a Holter monitor. You wouldn't live outside of the USA by any chance?

Best of luck and health,,,
569980 tn?1228333085
I've been on Metoprolol for almost 3 weeks now.  I was on 50 mg/day and told to take the pill at night.  The second night on it I got sick to my stomach, passed out in the bathroom, hit my head on the tub and ended up in the ER with 8 stitches.  I guess for some people its mild, but it hit me pretty hard.  I was reduced to 25 mg/day but I'm still having short runs of SVT.  On the 25 mg/day at firsst I was sleepy during the day with headaches that lasted all day.  My hands and feet were falling asleep (tingly) during exercise.  Almost 3 weeks later, the headaches and sleepiness aren't as bad.  My body is probably adjusting.  I'm still planning on a consultation with an EP for possible ablation (if I'm a candidate).
Avatar universal
The prescription you have is for metoprolol tartrate, which is NOT the extended release version, even though it is often prescribed to take one tablet daily.  I, too, had the side effects that you described when I was taking it and my cardiologist switched me to metoprolol succinate, the extended release version, before I finally went on atenolol.  All these meds cause reduced libido as a side effect, and the severity depends on the dosage.  It will take some adjustments over time in order to get you to an optimum dosage on any beta-blocker.  I switched from the tartrate version after about a month because it seemed that my heart was "fighting" the darn stuff and causing really uncomfortable arrhythmias  
Avatar universal
Thanks alot for your reply. I must admit I'm afraid to pass out now... but I'm always worried with new medication.

I'm starting to wonder if there are any success stories with all the negative stuff I'm reading.. do you guys/gals know of people who's symptoms go away after taking them for a week or more and have normal lives?
Avatar universal

My earlier story was (sort of) a success story.

I was having thousands of PVC's with mild tachy daily, and it's down to hundreds. My PVC's were strong, and I could feel them in my neck. Now my PVC's feel "mushy", and I don't feel a blood rush any more. I have been on generic Metoprolol XL 50mg for 1 month, and now 25mg for 1 month.

As I said, there were significant side effects, especially on 50mg. The side effects on 25mg seem to be slowly lessening, and they sure beat the nagging, incessant PVC's and tachy.
Avatar universal
Thanks alot.

BTW, I'm just worried, because some sites say that these Beta-1 Beta Blockers like Metoprolol can cause heart failure and things like that, but does this occur frequently ?
And also, I sometimes get like heart cramps. They don't last for long, maybe 1-2 seconds, but seem to occur often. Should I be worried that I will die?

Anyhow, thanks alot for your "sort of" success story. Atleast you seem much better.
Avatar universal
I am a 30 year old female. I am trying to stop taking Met. Tartrate after 2 years. I never thought my medicine was causing me to be so sick & thought it was MVP, but I'm happy to say my heart is healthy. I'm wondering how anyone can handle this lifestyle, but I think I have extreme symptoms-major chest pain daily, confusion, extreme fatique & lightheadedness. I would like to detox this drug from my system safely & hope you may know from experience.
Avatar universal
I also am 1 of many, I have had psvt since I was around18-20. I have had 18 differentdrugs perscribed over the years and broke through all of them but the one you are taking. I have been on it for 6 years and yea it has side effects but they are nothing compared to the tachycardia. The side affects level out after a while. The best thing for me is to take it at the same time everyday and I can not use the generic I break through it. My side affects are the cold hands and feet, being sleepy somtimes  tingles in arms feet and legs, not very offten but a will get dizzy if I stand to fast. I am a female but from my point of veiw has not had an effect on my sex drive. You will have  to be on some form of meds because if your DR has not told you if you let your heart rate stay at a fast rate your heart will enlarge. If your heart becomes enlarged then you have even more problems, an enlarged heart might lead to transplant. So they side affects mat not be so bad. My tachycardia was horrible, my heart rate was around 130-138 at rest and 160-180 awake and when I would excercise  it would be way over 200 my bp was 145 over 100 most days because of the fast heart rate. Now at rest it is 70 and when I work out it is about 180 my bp is 117 over 70. I truly believe that reducing my number have added years to my life. I am 50 by the way. My problem is now I have I000's of palps per day, they are very hard to deal with, somtimes beta blockers can contribute to palps. double edge sword isn't it? I wish you luck and a long life. Take care
Avatar universal
Hi Amlove,

This is really coincidential, 'cause 1 - I posted this last year on July 30th as I started on the Met. All replies I got were that same week, and no comments since... except the day that I just came completely off Met now (as in Today). So my experience may help, but, at the same time, I am no doctor, so please do not take this for final word.

When you say "& thought it was MVP", do you have MVP or is your heart (according to doctors) healthy? There's also the paranoia, the selective hypocondria in my case where everything heart-related started to freak me out thinking my heart was gonna fail, but I started thinking more objectively on the subject lately and wanted to get rid of a medication that was causing me to feel f'd up as it does to you as I can read. My first fear in making a withdrawal and finally cease was: will my initial condition (SVT's / tachycardia) kick back in or am I better at the way I'm going on now (few weeks ago) where my pulse was average 40 at rest, often causing dizziness, as well as other impairements such as sexual dysfunction (which is pretty hard on a 27 year old guy such as I). So I had to condition myself to: my condition last year (palps and everything) was a temporary part of my life, cuz even sustained tachycardia as I had (lasting over 2 months) can end up dissipating. When a heart functional problem, or thyroid and everything is ruled out, it can be many things, such as anxiety or mental blocks or whatever. Of course, I had been anxious all my life so the excuse "yeh but I don't think it may be anxiety cuz it never had been that bad all my life" doesn't go through. So if your heart is healthy and you don't have heart disease/problems, and if your blood pressure is normal (I don't know the initial reason of your treatment) then I'd go for it. I feel much better. Thing is, don't stop at once. What is your dose? I cut to halves insicde one week, 1/4 the next 2-3 weeks until I decided I was mentally prepared to stop without psychosaumatically causing myself anxiety that could have caused the initial condition. Of course, last year I was in a very severe drug withdrawal therefore my nervous system was more prone to making my body go nuts such as my heart rate, but if you are determined, you can go about it.

I also informed myself at the pharmacist and he told me getting off could be done in 4-7 days (gradually). I guess it all depends on the way you handle it, but if you are taking a relatively high dose OR are very sensitive to the drug, I suggest you taper off slowly like 2-4 weeks that way your conscience is clear and you don't have to stress about it. But then again, maybe you're stronger than I am in that domain.
Avatar universal
I actually came off Metoprolol today after 3 weeks' tapering. So far, cuz the last two weeks I was at such a minmal dose that it could be considered as though I'm off for 2 weeks now, and my condition seems to have gone, thankfully. Of course I still get palps, but they are no longer over long periods of time (like 24/7 last year).

I'm just concerned though, being a bit of a hypocondriac wehen it comes to heart issues... this heart enlargement leading to needing a transplant, is that likely to happen if now I would only have palp's a couple times a day?
Avatar universal
I am a 20 year old female. In December 2009, I developed an infection from a lip ring that traveled to my heart. I was placed in the critical care unit for 3 days with PSVT. After tons of testing, all EKGs, 2D echos, etc, everything was appearing to be fine. However, I kept getting the tachycardia even after I left the hospital. Some episodes would only last a minute. As time went on, they started occuring more often & lasting longer. My longest episode lasted about 2 hours. I actually had to pull over on the side of the road to keep from passing out even though I was already sitting. I went to the ER & had a heartrate of 181. Not lethal but definitely not safe. Again, all of my tests were normal & I had a great heart rhythm, just way too fast. They gave me Ativan through my IV & I had extreme hallucinations, amnesia, confusion, & slept for about 20 hours before finally coming off of it. My ER doctor gave me Metoprolol Tartrate in the hospital & suggested that I talk to my cardiologist about staying on it permanently. It has worked WONDERS for me. Let me start by saying that I hate drugs. I won't even take an Aleve if I have a headache. I normally do not react well with any type of drugs so I'm always really hesitant to take them. I take 50mg in the morning & 50 at night. I have not had a single episode of tachy whatsoever. Absolutely zero side effects. When I first started taking it, I did get very dizzy but it didn't last long. Now I am feeling great & it has also helped with my anxiety tremendously. My heartrate is now in the 70s & I will probably be on Metoprolol for the rest of my life. All I can say is that you have to take a chance. If it makes you feel any better, you should start taking the medicine at home & make sure that someone is there with you incase you have a bad reaction or you just don't want to be alone. Drugs affect everyone differently. For instance, I am not allergic to shellfish at all but I am allergic to the iodine contrast that you get during a CAT scan. It really all depends on your body but it's worth a shot. Good luck!
Avatar universal
After a couple weeks of taking 25mg of Metoprolol Tartate..I started having anxiety in my chest,  weird beats in my heart..even a little chest pain..but after 3 or 4 days it all went away..I have had sinus tach for 40+ years and was told I need to start slowing my heart rate down..an echo showed mild left side enlargement..so I decided to start medication..I'm 50 years old..the medication has worked well..no more side effects..I'm actually taking 37.5 mg a day a pill an a half in the morning and again at night..so my usual hr was 120's now it's 80s only been about 4 months so may need to go up a little more..but my blood pressure has always been good..so I don't wNt to drop it too low
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